UK: Dupuytren's Contracture: An Industrial Disease

Dupuytren's Contracture (DC) is a condition that affects the
sufferer by causing a thickening of the tissue located in the palm
of the hand. In severe cases it can cause the fingers to bend
inwards towards the palm of the hand causing difficulties in
straightening the fingers. The condition bears the name of Baron
Guillaume Dupuytren, who first described it in 1831. It is
sometimes also referred to as "Miner's Claw".

This condition has various established non-occupational causes
including diabetes, epilepsy, heavy alcohol consumption and
cirrhosis of the liver. In the past a number of studies have been
carried out and there have been conflicting medical opinion on
whether this condition could also have occupational causes.

Recognition as an industrial disease

The Industrial Injuries Advisory Council (IIAC) is an
independent statutory body set up in 1946 to advise the Government
on whether a list of prescribed diseases for which benefit may be
paid should be enlarged or amended. In 2006 IIAC carried out a
review of work-related upper limb disorders and found that the data
available was insufficient to meet the normal threshold for
prescription for DC. In January 2011 IIAC were again asked to
review the position in relation to coal mining by a Member of
Parliament. In particular IIAC were tasked with reviewing the link
between the development of DC and work involving hand-transmitted
exposure to vibration. IIAC's report was published in May 2014
and this recommended that DC be added to the list of prescribed
diseases for which Industrial Disablement Benefit is payable
following work for 10 or more years which involves use of hand-held
power tools.

It should also be noted that other work-related upper limb
disorders that can be caused by using vibratory tools, Vibration
White Finger and Carpal Tunnel Syndrome, have already been added to
the list of prescribed diseases.

IIAC's report states that DC has established
non-occupational causes and does not have clinical features that
differ in cases alleged to arise in an occupational context. It
goes on to say that the argument for prescription therefore rests
on reliable evidence of a doubling or more of risk in exposed
workers. A full review of the relevant medical studies was carried
out and the report notes that some of these lacked a clear account
of the tools giving rise to exposure and their magnitude of
exposure. However, what is commented on as being
"striking" in the report is the consistency with which
increased risk was reported (whilst using hand-held vibratory
tools) above IIAC's threshold of two.

IIAC recommends that the condition is added to the list of
prescribed diseases for which benefit is payable on the following
basis:

Any occupation involving the use of hand-held powered tools
where the use of those tools amounts to a
period or periods in aggregate of at least 10 years and
were within those period(s).

The use of those tools amounts to at least two hours per day
for three or more days per week.

Onset of symptoms should be after first exposure to the
tools.

It is IIAC's view that the presence of any non-occupational
risk factors for DC should not be construed as ground for rebuttal
of presumption assuming the qualifying conditions referred to above
are met.

Ramifications of the decision

It has been reported that union leaders are celebrating
IIAC's decision and it is suggested that some unions provided
IIAC with supportive evidence. Claimant solicitor firms have wasted
no time and a number have posted articles about this decision and
encouraged potential claimants to contact them to obtain legal
advice and assistance in relation to any application for benefit
for this condition. Once IIAC's decision has been ratified and
IIDB is available to claim for this condition we will need to
review the number of claims for benefit that are received and see
whether there is any trend for common law compensation claims to be
brought in relation to DC.

In their report IIAC suggest that DC could arise, from manual
aspects of using heavy industrial equipment and not solely from the
use of vibratory tools. Employers therefore need to focus on both
reducing exposure to vibratory tools and take appropriate risk
control measures in relation to manual handling.

The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.

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